[Ruptured abdominal aortal aneurysm in spite of endovascular aneurysm repair]

An 84-year-old man with an abdominal aortal aneurysm (AAA) was treated with endovascular aneurysm repair (EVAR). Four years later, the aneurysm ruptured and an emergency operation was performed. On a short-term basis, EVAR has been proven to be a low-risk treatment compared to open surgery. However, the EUROSTAR registry shows above 1% annual AAA-related deaths after EVAR due to late rupture or reintervention. Newer devices reduce the risk by approximately 50%, but this seems insufficient. Thus EVAR is still not a standardised option, but it may be appropriate in cases of rupture and cases that are not suited to open surgery.